BACKGROUND Chronic liver disease is an important cause of morbidity and mortality in the United States. A retrospective cohort study identified 2,353 patients with newly diagnosed chronic liver disease (63.9 cases/100,000 population). Extrapolating this incidence rate there will be approximately 150,000 patients with chronic liver disease diagnosed in gastroenterology clinics each year. Almost 20%, or an estimated 30,000 patients per year, had established cirrhosis at the time of presentation to the gastroenterologist.